Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | A47812 | CA |
NPI | 1023110103 |
---|---|
Provider Name | Mr. Nelson Guevara Madrilejo |
First Address | Bakersfield, CA 93301 |
Second Address | Bakersfield, CA 93301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 18/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E92541 | (02) |